The people who need the most often have the least, there is certainly always someone else who has more, and regardless, everyone thinks the money is being misused.
This can present policy makers with the temptation to stick to the status quo and preserve existing budgets.
This temptation must be resisted. From smoking bans to free personal care, there is strong evidence that reallocating resources to preventative spending works.
This idea underpinned the thinking of the Independent Care Review. He revealed that Scotland spends nearly £1billion on its ‘care system’, plus a further £875million to meet the needs of care-experienced adults failed by that same system. It is clear that the human cost of the lifelong “care system” is borne by those who have lived through it – and unforgivable.
Of course, there is an economic cost to shifting funds to the response, but morally we cannot afford not to.
Yet Scotland’s ‘care system’ is always at risk of continuing to reinvent itself in its own image – investing in crisis-responsive structures that would not be needed if preventative services and support were resourced and effective.
The time that has stood still is a long way off.
And that’s why the Scottish Government’s £500million Whole Family Welfare Fund is so important. It offers the possibility of in-depth reform of public services so that they surround families, providing them with the help and support they need, where and when they need it.
By 2026, it must be used to deliver the promised preventive public services, in order to avoid – as much as possible – the need for costly crisis interventions.
But the fund can go no further.
Proper discussion of how budgets can be truly invested in improving people’s lives is needed. It is far from obvious that large sums of public money in the construction of new prisons can be considered as investments, whereas the support of initiatives aimed at tackling the socio-economic factors which make it possible to fill them are not.
This will require increased efforts to overcome the difficulties of evaluating and measuring the long-term results which must be the objective of preventive spending.
Data collection needs to be refocused so that the evidence collected tells the story of real lives, not just what matters to the system. It is simply not possible to know if a person feels safer, more loved, more loved, by measuring the contribution of the services to their life.
For prevention spending to be sustained, the information collected must be shaped by what matters to children and families, and decisions must be made based on what is known, not just what can be quantified.
Above all, this requires a fundamental change. Our dogmatic approach to budgeting and policy impact assessment is not only unfair, it is inefficient.
To achieve all of this, those with money and power must make bold decisions. And Scotland needs them to be brave enough to stick with them.
If now is not the time to refocus on preventive spending, when?
Morally, we cannot afford not to.
Fiona Duncan is Chair of The Promise, the body responsible for ensuring the Independent Care Review’s findings are implemented, and CEO of Corra